Antimicrobial Susceptibility Test Discs · Antimicrobial Susceptibility Test Discs As per CLSI (Clinical Laboratory Standards Institute) Guidelines (Formerly NCCLS) Susceptibility

Antimicrobial Susceptibility Test DiscsAs per CLSI (Clinical Laboratory Standards Institute) Guidelines (Formerly NCCLS)

Susceptibility Test Procedure

Precaution

Note

1. Prepare plates with Mueller Hinton Agar (AM1071/AM5071) for use in the Bauer-Kirby Method for rapidly growing aerobic organisms. For fastidious organisms such as Streptococci, the agar (AM1071/AM5071) is supplemented with 5% sterile, defibrinated blood. For spp. Haemophilus Test Medium and for , GC Agar Base (AM1046/AM5046) with 1% defined growth supplement are recommended respectively. The medium in the plates should be sterile and have a depth of about 4 mm.

2. Use pure cultures as inoculum. Select 3-4 similar colonies and transfer them into about 5 ml of suitable broth such as Tryptone Soya Broth (AM1092/AM5092). Incubate at 35-37 C for 2-8 hours till light to moderate turbidity develops. Adjust the turbidity to yield a uniform suspension containing 10 – 10 cells/ml [i.e. 0.5 MCFarland standard (Cat. No.: 20701040)]. If the turbidity in the broth is sufficient, further incubation is not necessary.

3. Dip a sterile non-toxic cotton swab on a wooden applicator into the standardized inoculum (turbidity so adjusted, as to obtain confluent growth on the petri plate) and rotate the soaked swab firmly against the upper inside wall of the tube to express excess fluid. Streak the entire agar surface of the plate with the swab three times, turning the plate at 60 angle between each streaking. Allow the inoculum to dry for 5 – 15 minutes with lid in place.

4. Apply the discs using aseptic technique. Deposit the discs with centers at least 24 mm apart. For fastidious organisms and for Penicillins and Cephalosporins, the discs should preferably be deposited with centers 30 mm apart.

5. Incubate immediately at 35-37 C and examine after 16-18 hours or later if necessary. Measure the zones showing complete inhibition and record the diameters of the zones to the nearest millimeter.

1. Accuracy of the test depends on the disc potency, proper inoculum, functional pretested medium plates (nature of medium and its depth), inoculation technique, incubation temperature and time etc.

2. To maintain the potency of discs, store the stock containers of discs in the freezer at -20 C. The discs when required for use within a week , may be kept in refrigerator (below 8 C) and the remainder should be kept with desiccant and tightly closed container caps in the freezer.

3. Remove the antimicrobial discs from refrigerator to room temperature 1-2 hours before use to avoid moisture condensation. Return unused discs to refrigerator immediately after applications.

4. Once a cartridge is opened it is recommended that it is stored for no more than one week.5. While reading results:

(a) Ignore swarming of species if zones of inhibition are clearly defined.(b) Measure the sulphonamide zones at the margin of heavy growth since Sulphonamide may not inhibit organisms for several

generations and slight growth may appear within zones of inhibition.(c) Subculture, reidentify and retest any large colony growing within a clear zone of inhibition.

6. Control tests using known cultures should be included each time a sensitivity test is performed.7. Antibacterial agents other than those listed in interpretative chart are in current use. Susceptibility tests employing these agents

should be interpreted on the basis of presence or absence of a definite zone of inhibition and should be considered as only qualitative until the time interpretative zones have been established.

1. Ampicillin disc is used for testing susceptibility to amoxycillin as well.2. Cephalothin disc is used for testing susceptibility to Cephapirin, Cephaloridine, Cephalexin, Cefaclor, Cephoxitin, Cefazolin,

Cephradine and Cephadroxil as well.3. The Sulfisoxazole (Suphafurazole) disc can be used to represent any of the currently available sulfonamide preparations.4. The category “Intermediate” should be reported. Infections with bacteria of intermediate susceptibility may be considered

moderately susceptible and may respond to antimicrobial agents with a wide safe dosage range.5. Since certain strains of spp. have been reported to give false susceptible results with Cefprozil discs, strains of this

genus should not be tested & reported with this disc.6. All isolates with zone diameters of 14 mm or less should be tested by an MIC (Minimal Inhibitory Concentration)

method.7. When testing Vancomycin against , plates should be held a full 24 hrs & examined using transmitted light; the presence

of a haze or any growth within the zone of inhibition indicates resistance.8. Ofloxacin susceptible will also be susceptible to Levofloxacin.9. Susceptibility & resistance to Azithromycin, Clarithromycin & Dirithromycin can be predicted by using Erythromycin for

.10. The expiry date of the product is mentioned only on carton and pouch.11. Biogram antimicrobial susceptibility test disc dispenser is provided inside the carton.

Haemophilus N. gonorrhoeae

Proteus

Providencia

staphylococcal

Enterococci

S. pneumoniae

Streptococci

0

5 6

0

0

0

0

TMBiogramTM

BIOGRAMTM

Zone Size Interpretative Chart(Based on results obtained using Mueller Hinton Agar)

Productcode

Antimicrobial Agent Symbol

Diameter of zone of inhibition in mm

Quality Control, Limits

Disc content

Resis-tant mmor less

Inter-mediate mm

Sensi-tive mmor more

E.coli S.aureus P.aeru-ginosa

E.coli H.influ-enzae

H.influ-enzae

S.pneu-moniae

N.gonorr-hoeae

ATCC25922

ATCC25923

ATCC27853

ATCC35218

ATCC49247

ATCC49766

ATCC49619

ATCC49226

AK 30 mcg 14 15-16 17 19-26 20-26 18-26 - - - - -AAMK00030010

AAMC00010005 AMCAAMC00010010 When testing spp.

and When testing

AMPA00010005 AMP 10 mcgAMPA00010010 When testing 13 14-16 17 16-22 - - 6 - - - -

When testing 28 - 29 - 27-35 - - - - - -When testing spp. 18 19-21 22 - - - - 13-21 - - -When testing - - - - - - - - - 30-36 -When testing 18 19-25 26 - - - - - - - -other than When testing spp. 16 - 17 - - - - - - - -

AASA00010005AASA00010010 When testing 11 12-14 15 19-24 29-37 - 13-19 - - - -

and When testing spp. 19 - 20 - - - - 14-22 - - -

AAZT00015005AAZT00015010 When testing spp. - - 12 - - - - 13-21 - - -

AAZR00030005 AT 30 mcgAAZR00030010 When testing and 15 16-21 22 28-36 - 23-29 - - - - -

When testing spp. - - 26 - - - - 30-38 - - -

ACRB00100005ACRB00100010 When testing 19 20-22 23 23-29 - - - - - - -

When testing 13 14-16 17 - - 18-24 - - - - -

ACFA00030005 CF 30 mcgACFA00030010 When testing - - - - - - - - -

ACZN00030005 CZ 30 mcg 14 15-17 18 21-27 29-35 - - - - - -ACZN00030010

ACFD00005005 CDRACFD00005010 When testing 16 17-19 20 24-28 25-32 - - - 24-31 - -

and When testing - - - - - - - - - - 40-49When testing - - - - - - - - - 26-31 -

ACFP00030005 CPM 30 mcgACFP00030010 When testing 14 15-17 18 31-37 23-29 24-30 - - - - -

and When testing spp. - - 26 - - - - 25-31 - - -When testing - - 31 - - - - - - - 37-46When testing other 21 22-23 24 - - - - - - - - than When testing - - - - - - - - - 28-35 -

ACFI00005005ACFI00005010 When testing 15 16-18 19 23-27 - - - - - - -

When testing spp. - - 21 - - - - 25-33 - - -When testing - - 31 - - - - - - - 37-45When testing - - - - - - - - - 16-23 -

ACEF00075005 CPZ 75 mcg 15 16-20 21 28-34 24-33 23-29 - - - - -ACEF00075010

ACFT00030005 CTX 30 mcgACFT00030010 When testing spp.

When testing When testing 25 26-27 28 - - - - - - - -other than When testing - - 31 - - - - - - - 38-48

ACPD00010005 ACPD00010010 When testing 17 18-20 21 23-28 19-25 - - - - - -

and When testing spp. - - 21 - - - - 25-31 - - -When testing - - 29 - - - - - - - 35-43When testing - - - - - - - - - 28-34 -

Amikacin

Amoxycillin / C lavulanic acid

Ampicillin

Ampicillin / Sulbactam

Azithromycin

Aztreonam

Carbenicillin

Cefaclor

Cefazolin

Cefdinir

Cefepime

Cefixime

Cefoperazone

Cefotaxime (Cephotaxime)

Cefpodoxime

AAMK00030005

AMKV00030005

20/10mcg 19 - 20 - 28-36 - 17-22 15-23 - - -

AMCV00010005 (30mcg)13 14-17 18 18-24 - - - - - - -

AMPV00010005

A/S 10/10 mcg

AASV00010005

AZM 15 mcg 13 14-17 18 - 21-26 - - - - 19-25 -

AZTV00015005

AZRV00030005

CB 100 mcg

ACBV00100005

14 15-17 18 23-27 27-31 - - - 25-31 - -24-32 -

ACAV00030005

ACNV00030005

5 mcg

ACDV00005005

ACPV00030005

CFM 5 mcg

ACFV00005005

ACEV00075005

14 15-22 23 29-35 25-31 18-22 - - - - -- - 26 - - - - 31-39 - - -

ACTV00030005 - - - - - - - - - 31-39 -

CPD 10 mcg

APDV00010005

Haemophilus Staphylococci

Enterobacteriaceae

EnterobacteriaceaeStaphylococciHaemophilus S.pneumoniaeStreptococcus

S. pneumoniaeEnterococcus

Enterobacteriaceae Staphylococci

Haemophilus

Haemophilus

EnterobacteriaceaeP. aeruginosa

Haemophilus

P. aeruginosa

Streptococci

StaphylococciN. gonorrhoeaeS. pneum oniae

Enterobacteriaceae,P. aeruginosa Staphylococci

HaemophilusN. gonorrhoeaeStreptococcus

S. pneumoniaeS. pneum oniae

HaemophilusN. gonorrhoeaeS. pneum oniae

HaemophilusS. pneum oniaeStreptococcus

S. pneumoniaeN. gonorrhoeae

Enterobacteriaceae Staphylococci

HaemophilusN. gonorrhoeaeS. pneum oniae

Enterobacteriaceae

Enterobacteriaceae

Enterobacteriaceae


Productcode




Disc content


Inter-mediate mm




H.influ-enzae

S.pneu-moniae

N.gonorr-hoeae

ATCC25922

ATCC25923

ATCC27853

ATCC35218

ATCC49247

ATCC49766

ATCC49619

ATCC49226

ACFR00030005ACFR00030010 When testing 14 15-17 18 21-27 27-33 - - - 20-27 - -

and When testing - - - - - - - - - 25-32 -

ACFZ00030005ACFZ00030010 When testing spp. - - 26 - - - - 27-35 - - -

When testing - - 31 - - - - - - - 35-43

ACFX00030005ACFX00030010 When testing - - 38 - - - - - - - 42-51

When testing spp. - - 26 - - - - 29-39 - - -

ACTR00030005ACTR00030010 When testing spp. - - 26 - - - - 31-39 - -

When testing - - - - - - - - - 30-35 -When testing 24 25-26 27 - - - - - - - -other than When testing - - 35 - - - - - - - 39-51

ACFU00030005 CXM 30 mcg 14 15-17 18 20-26 27-35 - - - - - -ACFU00030010 When testing 25 26-30 31 - - - - - - - 33-41

When testing spp. 16 17-19 20 - - - - - 28-36 - -

ACPH00030005 CEP 30 mcg 14 15-17 18 15-21 29-37 - - - - 26-32 -ACPH00030010

ACHL00030005ACHL00030010 When testing spp. 25 26-28 29 - - - - 31-40 - - -

When testing 20 - 21 - - - - - - 23-27 -When testing 17 18-20 21 - - - - - - - -other than

ACIP00005005ACIP00005010 When testing spp. - - 21 - - - - 34-42 - - -

When testing 27 28-40 41 - - - - - - - 48-58

ACLR00015005ACLR00015010 When testing 16 17-20 21 - - - - - - 25-31 -

When testing 13 14-17 18 - 26-32 - - - - - -When testing spp. 10 11-12 13 - - - - 11-17 - - -

ACLI00002005ACLI00002010 When testing 14 15-20 21 - 24-30 - - - - - -

When testing 15 16-18 19 - - - - - - 19-25 -

ACOL00010005 CL 10 mcg 10 - 11 11-17 - 11-17 - - - - -ACOL00010010 (Methane Sulphonate)

ACOT00125005 (Trimethoprim /ACOT00125010 Sulphamethoxazole)

When testing 15 16-18 19 - - - - - - 20-28 -

ADEX00030005 DO 30 mcg 12 13-15 16 18-24 23-29 - - - - - -ADEX00030010

AETP00010005AETP00010010 When testing 15 16-18 19 29-36 24-31 - - - - - -

and spp.When testing spp. - - 19 - - - - 20-28 27-33 - -

AERY00015005AERY00015010 When testing 13 14-22 23 - 22-30 - - - - - -

spp.When testing 15 16-20 21 - - - - - - 25-30 -

AFUR00005005 FAR 5 mcg - - - 20-26 27-34 - - 15-22 - 27-35 -AFUR00005010

AGTI00005005AGTI00005010 When testing , 14 15-17 18 30-37 - 20-28 - - - - -

spp.When testing , 19 20-22 23 - 27-33 - - - - - -When testing spp. - - 18 - - - - 33-41 - - -When testing 17 18-20 21 - - - - - - 24-31 -When testing 33 34-37 38 - - - - - - - 45-56

AGEM00005005AGEM00005010 When testing 15 16-19 20 29-36 27-33 19-25 - - - 28-34 -

and When testing spp. - - 18 - - - - 30-37 - - -

Cefprozil

Ceftazidime

Ceftizoxime

Ceftriaxone

Cefuroxime

Cephalothin

Chloramphenicol

Ciprofloxacin

Clarithromycin

Clindamycin

Colistin

Co-Trimoxazole

Doxycycline Hydrochloride

Ertapenem

Erythromycin

Faropenem

Gatifloxacin

Gemifloxacin

CFR 30 mcg

AFRV00030005

CAZ 30 mcg 14 15-17 18 25-32 16-20 22-29 - - - - -

AFZV00030005

CZX 30 mcg 14 15-19 20 30-36 27-35 12-17 - - - 28-34 -

AFYV00030005

CTR 30 mcg 13 14-20 21 29-35 22-28 17-23 - - - - -

ACRV00030005

ACUV00030005

ACHV00030005

C 30 mcg 12 13-17 18 21-27 19-26 - - - - - -

ACLV00030005

CIP 5 mcg 15 16-20 21 30-40 22-30 25-33 - - - - -

AIRV00005005

CLR 15 mcg

ALRV00015005

CD 2 mcg

ALIV00002005

ACOV00010005

COT 1.25/ 10 11-15 16 23-29 24-32 - - 24-32 - - -23.75 mcg

AOTV00125005

ADEV00030005

ETP 10 mcg - - - - - 13-21 - - - 28-35 -

AETV00010005

E 15 mcg

AERV00015005

AFUV00005005

GAT 5 mcg

AGTV00005005

GEM 5 mcg

AGEV00005005

EnterobacteriaceaeStaphylococci

S. pneum oniae

Haemophilus N. gonorrhoeae

N. gonorrhoeaeHaemophilus

HaemophilusS. pneum oniaeStreptococcus

S. pneumoniaeN. gonorrhoeae


HaemophilusS. pneum oniae Streptococcus

S. pneumoniae

HaemophilusN. gonorrhoeae

StreptococciStaphylococciHaemophilus

StaphylococciStreptococci

S. pneum oniae

Enterobacteriaceae Staphylococcus

Haemophilus

Staphylococci,Entercoccus

Streptococci

EnterobacteriaceaeEnterococcus

StaphylococciHaemophilusStreptococciN. gonorrhoeae

Enterobacteriaceae Staphylococci,

Haemophilus


Productcode




Disc content


Inter-mediate mm




H.influ-enzae

S.pneu-moniae

N.gonorr-hoeae

ATCC25922

ATCC25923

ATCC27853

ATCC35218

ATCC49247

ATCC49766

ATCC49619

ATCC49226

AGNT00010005 GEN 10 mcg 12 13-14 15 19-26 19-27 16-21 - - - - -AGNT00010010

AIPM00010005AIPM00010010 When testing spp. - - 16 - - - - 21-29 - - -

AKAN00030005 K 30 mcg 13 14-17 18 17-25 19-26 - - - - - -AKAN00030010

ALEV00005005ALEV00005010 When testing , 15 16-18 19 - - - - - - - -

When testing , 13 14-16 17 29-37 25-30 19-26 - - - - - spp and .

When testing spp. - - 17 - - - - 32-40 - 20-25 -

ALIZ00030005ALIZ00030010 When testing & - - 21 - - - - - - - -

.When testing spp. 20 21-22 23 - - - - - - - -

ALOM00010005ALOM00010010 When testing 26 27-37 38 - - - - - - - 45-54

When testing spp. - - 22 - - - - 33-41 - - -

AMRP00010005AMRP00010010 When testing , 13 14-15 16 28-34 29-37 27-33 - - - - -

and When testing spp. - - 20 - - - - 20-28 - - -When testing - - - - - - - - - 28-35 -

AMIN00030005 MI 30 mcg 14 15-18 19 19-25 25-30 - - - - - -AMIN00030010

AMOX00005005AMOX00005010 When testing 20 21-23 24 - - - - - - - -

When testing spp. - - 18 - - - - - - - -When testing . 14 15-17 18 - - - - - - - -

ANLI00030005 NA 30 mcg 13 14-18 19 22-28 - - - - - - -ANLI00030010

ANTL00030005 (Netilm icin Sulphate) NET 30 mcg 12 13-14 15 22-30 22-31 17-23 - - - - -ANTL00030010

ANTR00300005 NIT 300 mcg 14 15-16 17 20-25 18-22 - - - - 23-29 -ANTR00300010

ANRF00010005ANRF00010010 When testing - - - - - - - - - 15-21 -

AOFL00005005AOFL00005010 When testing spp. - - 16 - - - - 31-40 - - -

When testing . 12 13-15 16 - - - - - - 16-21 -When testing 24 25-30 31 - - - - - - - 43-51When testing 14 15-17 18 - - - - - - - -

AOXN00001005AOXN00001010 When testing 10 11-12 13 - 18-24 - - - - - -

When testing coagulase 17 - 18 - - - - - - - -negative When testing - - - - - - - - - 12

APNC00010005 - APNC00010010 When testing 28 - 29 - 26-37 - - - - - -

When testing - - 20 - - - - - - 24-30 -When testing 19 20-27 28 - - - - - - - -other than When testing 26 27-46 47 - - - - - - - 26-34When testing 16 - 17 - - - - - - - -

APPR00100005APPR00100010 When testing

When testing 17 18-20 21 24-30 - - - - - - -

Gentamicin

Imipenem

Kanamycin

Levofloxacin

Linezolid

Lomefloxacin

Meropenem

Minocycline

Moxifloxacin

Nalid ixic Acid

Netillin

Nitrofurantoin

Norfloxacin

Ofloxacin

Oxacillin

Penicill in G

Piperacillin

AGNV00010005

AHLG00120005 HLG 120 mcg - - - - - - - - - - -AHLG00120010AHGV00120005

IPM 10 mcg 13 14-15 16 26-32 - 20-28 - - - - -

APMV00010005

AKAV00030005

LE 5 mcg

ALVV00005005

LZ 30 mcg - - - - 25-32 - - - - 25-34 -

ALZV00030005

LOM 10 mcg 18 19-21 22 27-33 23-29 22-28 - - - - -

ALOV00010005

MRP 10 mcg

AMRV00010005

AMIV00030005

MO 5mcg - - - 28-35 28-35 17-25 - 31-39 - 25-31 -

AMOV00005005

ANLV00030005

ANTV00030005

ANRV00300005

NX 10 mcg 12 13-16 17 28-35 17-28 22-29 - - - - -

ANFV00010005

OF 5 mcg 12 13-15 16 29-33 24-28 17-21 - - - - -

AOFV00005005

OX 1 mcg

AOXV00001005

-

P 10 units

APNV00010005

PI 100 mcg17 - 18 - - 25-33 12-18 - - - -

APPV00100005

Gentamicin

Haemophilus

StaphylococciEnterobacteriaceae

Enterococcus StreptococciHaemophilus

Staphylococci Streptococci

Enterococcus


EnterobacteriaceaeStaphylococci P.aeruginosa

HaemophilusS. pneum oniae

StaphylococciHaemophilusStreptococci

S. pneum oniae

HaemophilusStreptococciN. gonorrhoeaeStaphylococci

Staphylococci

StaphylococciS. pneum oniae

StaphylococciS. pneum oniae Streptococcus

S. pneumoniaeN. gonorrhoeaeEnterococcus

P. aeruginosaEnterobacteriaceae

< 0


Productcode




Disc content


Inter-mediate mm




H.influ-enzae

S.pneu-moniae

N.gonorr-hoeae

ATCC25922

ATCC25923

ATCC27853

ATCC35218

ATCC49247

ATCC49766

ATCC49619

ATCC49226

APIT00100005APIT00100010 When testing 17 18-20 21 24-30 - - 24-30 - - - -

When testing &17 - 18 - 27-36 25-33 - - - - -

When testing spp. - - - - - - - 33-38 - - -

APOL00300005 PB 300 units 11 - 12 13-19 - 14-18 - - - - -APOL00300010

ARFM00005005ARFM00005010 When testing - - - 8-10 - - - - - - -

When testing spp., 16 17-19 20 - 26-34 - - 22-30 - - - and spp.

When testing 16 17-18 19 - - - - - - 25-30 -

ASPR00005005ASPR00005010 When testing - - - 30-38 - - - - - - -

When testing - - - - - - - - - - 43-51When testing spp. - - - - - - - 32-40 - - -

ASPT00100005 SPT 100 mcg 14 15-17 18 - - - - - - - 23-29ASPT00100010

ASTR00010005 S 10 mcg 11 12-14 15 12-20 - - - - - - -ASTR00010010 - - - - 14-22 - - - - - -

ATEI00030005 TEI 30 mcg 10 11-13 14 - 15-21 - - - - - -ATEI00030010

ATTR00030005ATTR00030010 When testing spp. 25 26-28 29 - - - - 14-22 - - -

When testing spp. 18 19-22 23 - - - - - - 27-31 -When testing 30 31-37 38 - - - - - - - -30-42

ATIC00075005ATIC00075010 When testing 14 - 15 - - 21-27 6 - - - -

When testing 14 15-19 20 24-30 - - - - - - -

ATCC00075005ATCC00075010 When testing 14 15-19 20 24-30 - - 21-25 - - - -

When testing 14 - 15 - - 20-28 - - - - -When testing 22 - 23 - 29-37 - - - - - -

ATBR00010005 TOB 10 mcg 12 13-14 15 18-26 19-29 19-25 - - - - -ATBR00010010

ATRM00005005 TR 5 mcg 10 11-15 16 21-28 19-26 - - - - - -ATRM00005010

AVNC00030005AVNC00030010 When testing spp. - - 15 - 17-21 - - - - - -

When testing spp. - - 17 - - - - - - 20-27 -When testing spp. 14 15-16 17 - - - - - - - -

Piperacillin/ Tazobactam

Polymyxin-B

Rifampicin

Sparfloxacin

Spectinomycin

Streptomycin

Teicoplanin

Tetracycline

Ticarcillin

Ticarcillin /

Tobramycin

Trimethoprim

Vancomycin

PIT 100/10 mcg

APIV00100005

APOV00300005

AULI00005005 PRU 5 mcg - - - 32-38 20-26 27-33 - - - - -AULI00005010AULV00005005

RIF 5 mcg

ARFV00005005

SPX 5 mcg 15 16-18 19 - 27-33 21-29 - - - 21-27 -

ASPV00005005

ASYV00100005

When testing ASRV00010005

AHLS00300005 HLS 300 mcg - - - - - - - - - - -AHLS00300010 When testing AHSV00300005

ATEV00030005

TE 30 mcg 14 15-18 19 18-25 19-28 - - - - - -

ATTV00030005

TI 75 mcg

ATIV00075005

TCC 75/10 mcg

ATCV00075005

ATBV00010005

ATRV00005005

VA 30 mcg

AVNV00030005

EnterobacteriaceaeStaphylococci

Haemophilus

E. coli,Enterococcus

Staphylococci HaemophilusS. pneumoniae

E. coliN. gonorrhoeaeHaemophilus

HaemophilusStreptococci N. gonorrhoeae

P. aeruginosaEnterobacteriaceae

EnterobacteriaceaeP. aeruginosaStaphylococci

Staphylococci StreptococciEnterococcus

P. aeruginosa

Staphylococci

Staphylococci

Prulifloxacin (Ulifloxacin)

Streptomycin

Clavulanic acid

Note: 1. For control limits of Gentamycin 120 mcg (AHLG00120005/AHLG00120010) use ATCC 29212, standard 16-23 mm (HLG).2. For control limits of streptomycin 300 mcg (AHLS00300005/AHLS00300010) use ATCC 29212, standard 14-20 mm (HLS).

∆ : For : Muller Hinton Agar.For Haemophilus spp: Haemophilus Test Medium; For : Muller Hinton Agar with 5% sheep blood;For : GC Agar Base with 1% defined growth supplement.

: Deterioration in Oxacillin disc content is bestassessed with QC organism ATCC 25923, with an acceptable zone diameter of 18-24 mm.

E. faecalisE. faecalis

E. coli, S. aureus, P.aeruginosa S. pneumoniaeN. Gonorrhoeae

S. aureus

q

Antifungal Susceptibility Test Procedure

Preparation of Inoculum

Susceptibility Test Procedure

Precautions:

Zone Size Interpretative Chart for Antifungal Agent(Based on results obtained on Mueller Hinton Agar + 2% Glucose + 0.5 mcg/ml Methylene Blue Dye Medium)

µ

,

1. Inoculum is prepared by picking five distinct colonies of approximately 1mm from 24 hours old culture grown on SabouraudDextrose Agar (AM1087/AM5087) incubated at 35-37 C. Colonies are suspended in 5 ml of sterile 0.85% Saline.

2. Vortex the resulting suspension and adjust the turbidity to yield 1 x 10 - 5 x 10 cells/ml [i.e. 0.5 MCFarland standard (Cat. No.: 20701040)].

1. Prepare plates with Mueller Hinton Agar (AM1071/AM5071) +2% Glucose and 0.5 g/ml Methylene Blue Dye (GMB) Medium forcarrying out susceptibility of antifungal discs. The medium in the plates should be sterile and have a depth of about 4 mm.

2. Dip a sterile non-toxic cotton swab on a wooden applicator into the standardized inoculum (turbidity so adjusted, as to obtain semiconfluent growth on the petri plate) and rotate the soaked swab firmly against the upper inside wall of the tube to express excessfluid, Streak the entire agar surface of the plate with the swab three times, turning the plate at 60 angle between each streaking.Allow the inoculum to dry for 5-15 minutes with lid in place.

3. Apply the discs using aspectic technique. Deposit the discs with centers at least 24 mm apart.4. Invert the plates and place in an incubator set to within 15 minutes after the discs are applied.5. Examine each plate after 20-24 hours of incubation. If plate was satisfactorily streaked the resulting zones of inhibition will be

uniformly circular and there will be a semi-confluent lawn of growth. Read at 48 hours only when insufficient growth is observedafter 24 hours incubation.

1. Accuracy of the test depends on the disc potency, proper inoculum, functional pretested medium plates (nature of medium and itsdepth), inoculation technique incubation temperature and time, etc.

2. To maintain the potency of discs, store the stock containers of discs in the freezer at -20 C. The discs when required for use withina week, may be kept in refrigerator (below 8 C) and the remainder should be kept with tightly closed container caps in the freezer.

3. Remove the antimicrobial discs from refrigerator to room temperature 1-2 hours before use to avoid moisture condensation.Return unused discs to refrigerator immediately after applications.

4. Measure the zone diameter to the nearest whole millimeter at the point at which there is prominent reduction in growth. Pinpointmicro colonies at the zone edge or large colonies within a zone are encountered frequently & should be ignored.

0

6 6

0

0

0

* :

. .

35-37 C0

Zone diameter, Nearest whole (mm) Quality Control Limits

AFLC00025005 Fluconazole FLC 25 mcg 14 15-18 19 28-39 22-33 26-37 - 25-30 -AFLC00025010

AVRC00001005 Voriconazloe VRC 1 mcg 13 14-16 17 31-42 28-37 - 16-25 30-40 29-38AVRC00001010

Product Antimicrobial agent Symbol Disc Resistant S- DD* SensitiveCode

C.albicans C.parapsilosis C.tropicalis C. krusei C.albicans S.cerevisiae content mm or less mm or more ATCC 90028 ATCC 22019 ATCC 750 ATCC 6258 ATCC 10231 ATCC 9763

AFLV00025005

AVRV00001005

S - DD - Susceptible - Dose Dependent

1. 2. Method for Antifungal Disk Diffusion Susceptibility Testing of Yeasts; Approved Guidelines Vol 24 No. 15, May 2004 NCCLS document M44-A. For more details refer to this volume

Reference:Bauer, Kirby, Sherris and Turck, 1966, Am. J. Clin. Path., 45:493.

3. Performance Standards for Antimicrobial Disk susceptibility Tests, CLSI Vol. 29 No. 3, Jan. 2009. For more details refer to this volume.

Quality Control Limits for Antibiotics not as per CLSI(Based on results obtained using Mueller Hinton Agar)

Antibiotics concentration of these products are as per customer requirements. These codes do not have concentration of antibiotics as per CLSI (Formerly NCCLS) standards.


Quality Control Limits*

Product Antimicrobial Symbol D isc ATCC ATCC ATCC Code Agent Content 25922 25923 27853

E.coli S.aureus P.aeruginosa

ACIT00030005 Ceftriaxone/ CIT 30/10 mcg 29-35 24-32 17-24ACIT00030010 TazobactamAITV00030005

ACIT00080005 Ceftriaxone/ CIT 80/10 mcg 29-35 24-32 17-24ACIT00080010 TazobactamAITV00080005

ACHL00010005 Chloramphenicol C 10 mcg 17-25 19-26 -ACHL00010010ACLV00010005



ACIP00010005 Ciprofloxacin CIP 10 mcg 30-40 27-35 28-35ACIP00010010AIRV00010005

ACIP00030005 Ciprofloxacin CIP 30 mcg 30-40 27-35 28-35ACIP00030010AIRV00030005

AIRV00001005

ALIV00010005

AOOV00001005

AOOV00005005

AOOV00010005

AOOV00030005

ACOV00025005

ACOV00050005

ADEV00010005

AERV00010005

AERV00005005

AUEV00050005

AGNV00050005

AGNV00030005

AGTV00010005

AGTV00030005

AICV00010005

AKAV00005005

ALNV00002005

ALNV00010005

ALNV00015005

ALOV00030005

ALOV00015005

ANYV00030005

ANTV00010005

ACIP00001005 Ciprofloxacin CIP 1 mcg 26-36 20-28 22-30ACIP00001010

ACLI00010005 Clindamycin CD 10 mcg - 28-34 -ACLI00010010

ACOX00001005 Cloxacillin COX 1 mcg - 18-24 -ACOX00001010




ACOL00025005 Colis tin CL 25 mcg 11-15 - 11-15ACOL00025010 (Methane Sulphonate)

ACOL00050005 Colis tin CL 50 mcg 11-15 - 11-15ACOL00050010 (Methane Sulphonate)

ADEX00010005 Doxycycline DO 10 mcg 12-18 23-29 -ADEX00010010 Hydrochloride

AERY00010005 Erythromycin E 10 mcg - 22-30 -AERY00010010

AERY00005005 Erythromycin E 5mcg - 22-30 -AERY00005010

AFUR00050005 Furazolidone FR 50 mcg 20-25 18-22 -AFUR00050010

AGNT00050005 Gentamicin GEN 50 mcg 21-28 25-33 20-25AGNT00050010

AGNT00030005 Gentamicin GEN 30 mcg 21-28 24-32 19-24AGNT00030010

AGTI00010005 Gatif loxacin GAT 10 mcg 30-37 27-33 20-28AGTI00010010

AGTI00030005 Gatif loxacin GAT 30 mcg 32-40 31-37 24-32AGTI00030010

AICN00010005 Imipenam/ IC 10/10 mcg 28-35 - 24-31AICN00010010 Cilastin

AKAN00005005 Kanamycin K 5 mcg 16-22 19-26 -AKAN00005010

ALIN00002005 Lincomycin L 2 mcg - 15-22 -ALIN00002010

ALIN00010005 Lincomycin L 10mcg - 15-22 -ALIN00010010

ALIN00015005 Lincomycin L 15 mcg - 22-32 -ALIN00015010

ALOM00030005 Lomefloxacin LOM 30 mcg 27-33 23-29 22-28ALOM00030010

ALOM00015005 Lomefloxacin LOM 15 mcg 28-36 24-32 22-30ALOM00015010

ANOM00030005 Neom ycin N 30 mcg 17-23 18-26 -ANOM00030010

ANTL00010005 Netillin NET 10 mcg 17-25 20-29 13-19ANTL00010010 (Netilmicin Sulphate)



Product Antimicrobial Symbol D iscCode Agent Content


AAM K00010005 Am ikacin AK 10 mcg 16-23 18-24 15-23AAM K00010010

AAM X00010005 Am oxycillin AMX 10 mcg 19-25 28-36 -AAM X00010010



AAM C00050005 Am oxyclav AMC 50/10 mcg 24-30 30-38 -AAM C00050010 (Amoxycillin/

AAM S00030005 Am oxycillin/ AMS 30/15 mcg 28-38 32-43 -AAM S00030010 Sulbactam

AAM L00010005 Am oxyclav AMC 10 mcg 19-25 28-36 -AAM L00010010

AMPA00002005 Am pic illin AMP 2 mcg 14-21 27-35 -AMPA00002010

AMPA00025005 Am pic illin AMP 25 mcg 20-30 32-40 -AMPA00025010

AAAX00010005 Am pic illin/ AX 10 mcg 16-22 35-37 -AAAX00010010 Cloxacillin

AAZT00030005 Azithromycin AZM 30 mcg - 24-30 -AAZT00030010

AAZR00050005 Aztreonam AT 50 mcg 29-37 - 24-33AAZR00050010

AABC00010005 Bacitrac in B 10 units - 12-22 -AABC00010010

AABC00080005 Bacitrac in B 8 units - 12-22 -AABC00080010

ACFD00030005 Cefadroxil CPR 30 mcg 12-18 26-32 -ACFD00030010 (Cephadroxil)

ACFN00030005 Cefalex in CN 30 mcg 17-22 29-37 -ACFN00030010 (Cephalex in)

ACFP00050005 Cefepim e CPM 50 mcg 32-40 26-34 27-35ACFP00050010

ACTB00080005 Cefepim e/ CPT 80/10 mcg 31-39 30-35 27-34ACTB00080010 Tazobactam

ACTB00030005 Cefepim e/ CPT 30/10 mcg 33-39 24-30 26-32ACTB00030010 Tazobactam

ACCA00050005 Cefixime/ CMC 5/10 m cg 24-32 - -ACCA00050010 Clavulanic ac id

ACFS00030005 Cefoperazone/ CFS 75/30 mcg 27-33 23-30 22-28ACFS00030010 Sulbactum



ACST00075005 Cefoperazone/ CST 75/10 mcg 27-32 23-30 22-28ACST00075010 Tazobactam

ACFT00010005 Cefotaxime CTX 10 mcg 29-35 25-31 18-22ACFT00010010 (Cephotaxime)

ACPM00030005 Cefpirome CFP 30 mcg 28-34 29-37 23-29ACPM00030010

ACCL00010005 Cefpodoxime/ CCL 10/5 m cg 17-23 13-19 -ACCL00010010 Clavulanic ac id

ACZC00030005 Ceftazidime/ CAC 30/10 mcg 27-34 18-22 -ACZC00030010 Clavulanic ac id

ACAT00080005 Ceftazidime/ CAT 80/10 mcg 25-32 19-28 23-30ACAT00080010 Tazobactam

ACAT00030005 Ceftazidime/ CAT 30/10 mcg 25-32 17-24 22-29ACAT00030010 Tazobactam

ACTR00010005 Ceftriaxone CTR 10 mcg 29-35 22-28 17-23ACTR00010010

ACIS00030005 Ceftriaxone/ CIS 30/15 mcg 31-37 24-30 16-21ACIS00030010 Sulbactam

ATCC ATCC ATCC 25922 25923 27853

AMKV00010005

AAM V00010005

AAM V00025005

AAM V00030005

Clavulanic ac id)AMCV00050005

AMSV00030005

AMLV00010005

AMPV00002005

AMPV00025005

AAXV00010005

AZTV00030005

AZRV00050005

ABCV00010005

ABCV00080005

AFDV00030005

ANNV00030005

ACPV00050005

ABBV00080005

ABBV00030005

ACCV00050005

ACSV00030005

ACSV00010005

ACSV00050005

ACVV00075005

ACTV00010005

AMMV00030005

ALLV00010005

AZZV00030005

AAAV00080005

AAAV00030005

ACRV00010005

AIIV00030005

Quality Control Limits

ATCC 90028 ATCC 22019 ATCC 750 ATCC 6258 ATCC 10231 ATCC 9763Product Code Antimicrobial Agent Symbol Disc Content C.parapsilosis C.tropicalis C. krusei C.albicans S.cerevisiaeC.albicans

AAPB00100005 /

AAPB00020005 /

AAPB00050005 /

ACCE00010005 /

AFLC00010005 /

AITE00010005 /

AITE00030005 /

AKTE00010005 /

AKTE00030005 /

AKTE00050005 /

ANSN00100005 /

ANSN00050005 /

AAPB00100010 / AAPV00100005 Amphotericin-B AP 100 units 10-17 11-20 08-12 09-14 10-18 11-18

AAPB00020010 / AAPV00020005 Amphotericin-B AP 20 mcg 10-15 10-17 08-10 08-12 10-16 08-12

AAPB00050010 / AAPV00050005 Amphotericin-B AP 50 mcg 12-15 13-17 13-17 14-20 15-23 16-25

ACCE00010010 / ATCV00010005 Clotrimazole CC 10 mcg 18-32 16-30 10-20 14-24 12-18 17-25

AFLC00010010 / AFLV00010005 Fluconazole FLC 10 mcg 27-38 22-33 16-25 - 18-22 -

AITE00010010 / AIOV00010005 Itraconazole IT 10 mcg 16-20 11-18 08-13 08-15 18-22 -

AITE00030010 / AIOV00030005 Itraconazole IT 30 mcg 18-22 20-24 11-18 08-15 18-22 -

AKTE00010010 / AKTV00010005 Ketoconazole KT 10 mcg 20-32 14-29 17-28 10-14 18-22 -



ANSN00100010 / ANSV00100005 Nystatin NS 100 units 19-27 16-25 16-21 15-20 15-23 17-25

ANSN00050010 / ANSV00050005 Nystatin NS 50 mcg 19-23 19-23 13-17 19-26 16-25 22-27




Code Agent


ASRN00030005 Spiramycin SR 30 mcg - 22-29 -ASRN00030010ASNV00030005

ASRN000100005 Spiramycin SR 100 mcg - 22-29 -ASRN000100010ASNV000100005

ASTR00025005 Streptomycin S 25 mcg 15-23 17-25 -ASTR00025010ASRV00025005

ATTV00010005

ATBV00030005

ATRV00010005

ATRV00025005

ATRV00030005

ATLV00015005

AVNV00005005

AVNV00010005

AMTT00005010 / ATMV00005005

AMTT00004010 / ATMV00004005

ATTR00010005 Tetracyc line TE 10 mcg 18-25 24-30 -ATTR00010010

ATBR00030005 Tobramycin TOB 30 mcg 18-26 19-29 19-25ATBR00030010

ATRM 00010005 Trim ethoprim TR 10 mcg 21-28 19-26 -ATRM 00010010



ATLS00015005 Tylos ine TL 15 mcg - 22-30 -ATLS00015010

AVNC00005005 Vancom ycin VA 5 mcg - 15-19 -AVNC00005010

AVNC00010005 Vancom ycin VA 10 mcg - 17-21 -AVNC00010010

* : Expected diameter of zone of inhibit ion.

AMTT00005005 / Metronidazole MT 5 mcg

AMTT00004005 / Metronidazole MT 4mcg

Culture Response: Susceptibility test of Metronidazole discs (AMTT00005005 & AMTT00004005) is carried out by incorporating it into 5 ml Fluid Thioglycollate M edium (AM1045/AM5045). It is incubated at 35-37 C for 24 hours and results are recorded on the basis of appearance of growth us ing (ATCC 12924) as a test organism.

0 luxuriant1 good3 poor to good5 poor7 none* addition to 5 ml medium

Product Antimicrobial Symbol Disc Content

No. of Discs* Growth

0

Cl.perfringens





ANTR00100005 Nitrofurantoin NIT 100 mcg 20-25 18-22 -ANTR00100010ANRV00100005

ANTR00200005 Nitrofurantoin NIT 200 mcg 20-25 18-22 -ANTR00200010ANRV00200005

ANVV00030005

ANVV00005005

AOFV00002005

AOXV00005005

AOYV00030005

APFV00005005

APNV00002005

APOV00050005

APOV00100005

AULV00001005

ARFV00002005

ARFV00030005

ARFV00015005

AROV00030005

ANOV00030005 Novobiocin NV 30 mcg - 22-31 -ANOV00030010

ANOV00005005 Novobiocin NV 5 mcg - 22-31 -ANOV00005010

AOFL00002005 Ofloxac in OF 2 mcg 29-33 24-28 17-21AOFL00002010

AOXN00005005 Oxacillin OX 5 mcg - 27-35 -AOXN00005010

AOXY00030005 Oxytetracycline O 30 mcg 18-25 19-28 -AOXY00030010

APFC00005005 Pefloxac in PF 5 mcg 29-33 24-28 17-21APFC00005010

APNC00002005 Penicillin-G P 2 units - 26-37 -APNC00002010

APOL00050005 Polym yxin B PB 50 units 12-16 - 11-17APOL00050010

APOL00100005 Polym yxin B PB 100 units 12-16 - 11-17APOL00100010

AULI00001005 Prulifloxacin PRU 10 mcg 28-34 19-27 24-32AULI00001010 (Ulifloxacin)

ARFM00002005 Rifampicin RIF 2 mcg 8-10 26-34 -ARFM00002010

ARFM00030005 Rifampicin RIF 30mcg 9-12 32-40 -ARFM00030010

ARFM00015005 Rifampicin RIF 15mcg 8-10 26-34 -ARFM00015010

AROY00030005 Roxithromycin RO 30 mcg - 22-30 -AROY00030010

Quality Control Limit for Antifungal Agent not as per CLSI(Based on result obtained on Mueller Hinton Agar + 2% Glucose + 0.5 mcg/ml Methylene Blue Dye Medium)

Qarad b.v.b.a. Cipalstraat 3, B-2440 Geel, BelgiumEC REP

LOT

Use byLot Number

ROReceived on

-20 C0

8 C0

Store at -20-8 C0 Manufacturer

REFCatalogue Number

Consult Instructions for use

IVDIn vitro Diagnostic

Medical DeviceHygroscopic keep

container tightly closed

OOOpened on

H EC REPAuthorised

Representative

Documents

Antimicrobial Susceptibility Test Discs · Antimicrobial Susceptibility Test Discs As per CLSI (Clinical Laboratory Standards Institute) Guidelines (Formerly NCCLS) Susceptibility